Sarcopenia and its clinical correlation in elderly chronic obstructive pulmonary disease: a prospective cohort study.

OBJECTIVE: The aim of this study was to examine the effects of sarcopenia on clinical characteristics and short-term outcomes in elderly chronic obstructive pulmonary disease (COPD) patients. PATIENTS AND METHODS: One hundred twenty elderly COPD patients (age>60) recruited from Beijing Shijingshan Hospital were divided into sarcopenia and non-sarcopenia groups according to the severity of sarcopenia at the first admission. Baseline data, geriatric syndrome, laboratory indicators and body composition analysis were analyzed. One year followed-up by outpatient visits was focused on clinical characteristics and telephone follow-ups for collecting all-cause deaths and acute exacerbations of chronic obstructive pulmonary disease as end-point events. The risk factors for sarcopenia were analyzed by univariate analysis and multivariate logical regression. The proportional hazards model (COX) regression was performed to determine the effect of sarcopenia on COPD patients' prognoses. RESULTS: One hundred twenty patients (76 men and 44 women) with an average age of 76.7±8.78 years were included, of which 63 patients (52.5%) were diagnosed with sarcopenia. Compared to the non-sarcopenia group, the sarcopenia group exhibited worse lung function and more severe geriatric syndromes with significantly higher incidence ratios of somnipathy and frailty. The sarcopenia group also showed worse muscle indicators and declined body composition. Multivariate analysis showed that the occurrence of sarcopenia in elderly COPD patients was correlated with forced expiratory volume in the first second (FEV1) (OR=0.97, 95% CI: 0.94-1.0, p=0.035), body mass index (BMI) (OR=0.80, 95% CI: 0.71-0.89, p=0.035) and hemoglobin (OR=0.98, 95% CI: 0.96-1.0, p=0.023). Furthermore, the COX regression indicated the association of sarcopenia with acute exacerbations of COPD within the follow-up period (HR=2.4, 95% CI: 1.01-5.72, p=0.048). CONCLUSIONS: Sarcopenia increases the risk of acute exacerbations of chronic obstructive pulmonary disease in the elderly. Sarcopenia incidence in elderly COPD is associated with FEV1, BMI, and hemoglobin and closely monitoring indicators is useful for early diagnosis of sarcopenia.

[Application of failure mode and effect analysis in reducing the risk of nosocomial infection].

Objective: To explore the effect of failure mode and effect analysis (FMEA) in the management of nosocomial infection, and provide reference for the effective prevention and control of nosocomial infection. Methods: Using FMEA to identify, analyze, evaluate and screen out the high-risk events of nosocomial infection in January 2020, from which two hospital level priority improvement projects of hand hygiene compliance and blood-borne occupational exposure were determined. After risk control and intervention measures, the effects before and after improvement were compared. Results: Except for the lack of incentive mechanism and insufficient communication between medical and nursing teams, the differences in hand hygiene compliance and blood-borne occupational exposure risk priority coefficients before and after the implementation of FMEA were statistically significant (P<0.05) . After the implementation of FMEA, the hand hygiene compliance was 74.92% (79375/105953) , which was significantly higher than 68.40% (58361/85328) before the implementation of FMEA, and the difference was statistically significant (χ(2)=996.55, P<0.01) . The incidence of blood-borne occupational exposure after the implementation of FMEA was 3.85% (80/2080) , which was lower than the 6.16% (123/1998) before the implementation of FMEA, and the difference was statistically significant (χ(2)=11.49, P<0.01) . Conclusion: FMEA has a good effect in nosocomial infection management. It can identify and evaluate the risk of nosocomial infection prospectively, so as to control the risk effectively.

Cloning and expression analysis of innate immune genes from red sea bream to assess different susceptibility to megalocytivirus infection.

As suggested by the Office International des Epizooties (OIE), fishes belonging to the genus Oplegnathus are more sensitive to megalocytivirus infection than other fish species including red sea bream (Pagrus major). To assess the roles of the innate immune response to these different susceptibilities, we cloned the genes encoding inflammatory factors including IL-8 and COX-2, and the antiviral factor like Mx from red sea bream for the first time and performed phylogenetic and structural analysis. Analysed expression levels of IL-1ß, IL-8 and COX-2 and the antiviral factor like Mx genes performed with in vivo challenge experiment showed no difference in inflammatory gene expression or respiratory burst activity between red sea bream and rock bream (Oplegnathus fasciatus). However, the Mx gene expression levels in red sea bream were markedly higher than those in rock bream, suggesting the importance of type I interferon (IFN)-induced proteins, particularly Mx, during megalocytivirus infection, rather than inflammation-related genes. The in vitro challenge experiments using embryonic primary cultures derived from both fish species showed no difference in cytopathic effects (CPE), viral replication profiles, and inflammatory and Mx gene expression pattern between the two fish species.

All-trans-retinoic acid increased the expression of integrin alpha5beta1 and induced "anoikis" in SMMC-7721 hepatocarcinoma cell.

It is extensively shown that integrin can regulate various cellular functions, including apoptosis, probably by contributing to signal transduction processes through interaction with extracellular matrix (ECM) proteins. In the present study, DNA flow cytometric analysis demonstrated that SMMC-7721 hepatocarcinoma cells treated with 80 microM all-trans-retinoic acid (atRA) showed an increased expression of the integrin alpha5beta1, which was associated with the growth inhibition of the cells. We found that atRA treated cells showed obvious apoptosis. Then, it was postulated that the enhanced content of integrin alpha5beta1 in the absence of ligation with fibronectin (Fn) would stop transducing survival signals, and lead to decreased cell growth and apoptosis. To elucidate this hypothesis, we cultured the atRA treated cell in L-poly-lysine-coated and Fn-coated flask, respectively. The results indicated that Fn binding prevented the cells from apoptosis induced by atRA, in contrast to L-poly-lysine binding. When the transfectant with enhanced expression of integrin alpha5beta1 at the same level of atRA treated cell was cultured in L-poly-lysine-coated flask, apoptosis was triggered. However, apoptotic cell was not detected when those cells were cultured in Fn-coated flask. Meanwhile, culturing the transfectant in the antibody (against integrin alpha5 subunit)-coated flask induced 18.33% of the cells into apoptosis, which is far more than the control group. Our study suggests that increased expression of integrin alpha5beta1 on the surface of SMMC 7721 hepatocarcinoma cell treated by atRA, when unbound to Fn, would stop transducing survival signals to lead to "anoikis", and can be reverted by the interaction of integrin alpha5beta1 with Fn.

[GnT-V overexpression in human hepatocarcinoma cells affects its migration and expression of cell adhesion molecules].

The purpose of this paper is to study the effect of N-acetylglucosaminyltransferase V (GnT-V) overexpression on the migration of 7721 cells and its mechanism. The abilities of migration of both 7721 cells transfected with GnT-V cDNA and 7721 cells transfected with pcDNA3 was detected, the expressions of integrin and E-cadherin which are important adhesion molecules on surface membrane and closely related to the abilities of invasion and metastasis. Cell migration abilities were measured by the agarose drop explant method. Flow cytometric analysis (FACS) was applied to determine the relative amounts of integrin alpha 5 and beta 1 subunits on the cell surface while RTPCR was carried out to determine the expression of their mRNA. The expression of E-cadherin was examined by the immunocytochemical ABC method. Western blot analysis was carried out to examine the expression of beta-catenin. GnT-V overexpression enhanced evidently the migration ability of 7721 cells and increased the amount of integrin alpha 5 subunit to 2.9 times of that of control while the amount of beta 1 subunits was not significantly changed. Besides, the expressions of E-cadherin and beta-catenin were enhanced at different levels in GnT-V/7721 cells compared with mocked. The results suggested that the overexpression of GnT-V related to the production of N-linked sugar chains could promote the expressions of integrin, E-cadherin and beta-catenin on 7721 cells so that the migration ability of tumor cells was enhanced.